Pituitary gland, also known as hypophysis is responsible for carrying out several hormonal functions in the body. Hypophysectomy is the procedure of removing the pituitary gland from the brain. The surgery of pituitary is done mainly to remove either benign or malignant pituitary tumour. Pituitary gland is also called the master gland and is the most important part of the endocrine system. The hormones secreted by the pituitary gland are responsible for controlling various functions of the body like growth, sexual reproduction, metabolism etc. The cause of uncontrolled cell growth in the pituitary is still unknown but can be traced to heredity in some cases. Symptoms of pituitary tumour are severe headache and loss of vision. Hormonal deficiencies caused due to large pituitary tumours cause weakness, sexual dysfunction, unexplained weight gain or weight loss, chills, nausea, vomiting, irregular menstruation and frequent urination. Pituitary tumours also cause the pituitary to secrete more adrenocorticotropic hormone that stimulates the adrenal glands to produce excess cortisol hormone. Excessive cortisol secretion causes Cushing’s syndrome which in turn causes high blood pressure, acne, stretch marks, anxiety and depression, high blood sugar, easy bruising, thinning of the limbs, weakening of the bones, face becomes round and accumulates fats, fat accumulation in the upper back and middle portion of the body. To treat the above mentioned disorders, it is often recommended to undergo hypophysectomy.
Before the surgery is carried out the patient is recommended to take a few days off from work and normal activities and take ample amount of rest. On the day of the surgery the patient will be given general anesthesia to keep him/her unconscious. The procedure can be done by any one of the three different types. The types of hypophysectomy are transsphenoidal hypophysectomy, open craniotomy and stereotactic radiosurgery. In transsphenoidal hypophysectomy, the pituitary gland is removed from the brain through the nose. There is a cavity at the back of the nose, known as sphenoid sinus. The tumour is pulled out from the brain through this cavity with the aid of an endoscopic camera or a surgical microscope. The procedure involves making several small cuts under the upper lip, through the sinus cavity to reach the pituitary in the brain. Thereafter, with the help of forceps, the pituitary is removed. After taking it out, the vacant space is filled with cartilage, bone, fats and some other surgical objects. The surgeon Open craniotomy procedure involves cutting a small opening at the front of the skull through which the pituitary is taken out. If there are smaller tumours in and around the pituitary, it can be removed by stereostatic radiosurgery. This procedure involves destruction of the tumour cells in and around the pituitary gland.
Person showing the symptoms of pituitary tumour will be eligible for treatment. Experiencing severe headache and loss of peripheral vision will make the person eligible for the treatment.
People with headaches which normally go away after taking a painkiller and do not have lost vision are not eligible for hypophysectomy.
Yes, hypophysectomy has several risks and complications associated with it. The procedure done at any age affects the adrenal and thyroid glands. Hypophysectomy also affects reproductive system either after attaining sexual maturity or before it. The normal growth is also affected after hypophysectomy.
Post treatment guidelines for hypophysectomy are visiting the doctor after about 6 to 8 weeks after the surgery. In the meantime the patient is recommended not to blow or clean nose, not to swim or put head under water, not to resume normal activities and daily work too soon after the surgery, not to bend forward and avoid lifting heavy weights.
It takes about 2 hours for the treatment to complete. After the treatment it may take about a few weeks to recover from the disease.
The price of hypophysectomy in India may range from Rs. 50,000 to Rs. 1 lakh.
Yes the results of the treatment are permanent.
Alternative to hypophysectomy can be medication, radiation therapy with X-ray or gamma knife surgery that uses gamma rays to remove small tumours.